NPI | 1942481288 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 10634) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501013498) |
Enumeration Date | 2007-11-15 |
Last Update Date | 2022-12-07 |